Ultrastructure of platelet aggregation in refractory anemia and myelomonocytic leukemia. I. Ultrastructure of aggregation in normal controls and general defects in refractory anemia and myelomonocytic leukemia. In vitro aggregation of the platelets from four patients with refractory anemia and two patients with acute myelomonocyctic leukemia revealed distinctive abnormalities. In five patients, there was deficient or minimal aggregation with adenosine diphosphate (ADP), epinephrine, or collagen and only one wave of aggregation could be elicited with ADP at any concentration. Ultrastructural studies revealed numerous isolated platelets, small aggregates with few platelet pseudopods, and the presence of a characteristic type of aggregate with heterogeneous platelet composition combining features of both the primary and the secondary waves of aggregation. These "mixed aggregates" were particularly abundant in the four patients who had refractory anemia and may constitute the structural basis of the single wave of aggregation observed.


Chemoimmunotherapy of human solid tumors.


Immunotherapy of human leukemia with neuraminidase-modified cells.


Editorial: Leukemic reticuloendotheliosis: a defined syndrome of an ill defined cell.


Causes of death in adults with acute leukemia. The causes of death were investigated in 315 adults with acute leukemia during a 7-year period (1966-1972). Infection alone or in combination was the most common cause (75%), followed by hemorrhage (24%) and organ failure (9%). Most of the infections were either systemic or pulmonary. Seventy-five percent of the systemic infections and 72% of the pneumonias were caused by bacteria. Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa were the most frequent organisms isolated. After 1968, there was a sharp decrease in the number of fatal infections caused by Pseudomonas aeruginosa and a marked increase in the incidence of fatal infections caused by Klebsiella spp. and E. coli. Infections caused by Gram-positive cocci occurred in only 3% of the cases. The incidence of systemic fungal infections was 13%; most common fungi causing infection were Candida spp. and Aspergillus spp. Eighty-five percent of 159 patients with a terminal neutrophil count of less than 100/mm3 died of infection, compared to 48% of 62 patients with a terminal neutrophil count of greater than 1000/mm3. Hemorrhage was mostly due to thrombocytopenia (61%) and disseminated intravascular coagulation (12%). This study indicates that infection continues to be the most common cause of death in patients with acute leukemia. Although advances in antibiotic therapy have changed the distribution of causative organisms, ultimate control of infection requires further improvements in supportive care measures which rectify impairments in the patients' host defense mechanisms.


Risk factors of sports injuries in winter. During the winter season (1 April-31 August) of 1972, 2529 sporting injuries were treated in Wellington and Hutt Accident and Emergency Departments. A computerised analysis was made of the answers to a questionnaire filled out by each patient. Over 90 percent occurred playing major team sports, the majority while playing rugby (57 percent). The rate of injuries was found to be independent of the week of the season, socioeconomic status, race or position played, but was related to age, team sport, and grade played. The majority occurred during games in the weekend. Boys under 13 years of age are rarely injured whereas senior and older players are more frequently injured, especially in the second half of play. It is proposed that competition and the velocity of impact are important contributing factors in major sporting injuries.


Neonatal at risk factors, visual defects and the preschool child: A report from the Queen Mary Hospital multidisciplinary child development study. An experimental group of 142 children aged four years who had experienced neonatal at risk factors and a control group of 112 children whose perinatal histories were optimal had vision screening tests to detect defective vision or strabismus. Five (3.5 percent) in the at risk group and 10 (8.9 percent) in the control group (total 15, 5.9 percent) were found to have a visual defect. Of those, six had already been identified because of a manifest squint. Nine children with defective vision were first identified through the study. The importance of the early identification and treatment of visual disorders, particularly amblyopia, is emphasised, and recommendations are made for more widespread vision screening of preschool children.


Malakoplakia of the testis.

Malakoplakia of the testis. Two cases of malakoplakia of the testis are presented. Malakoplakia (soft plaque) is an uncommon chronic inflammatory condition of granulomatous type, the common denominator of which would appear to be an altered reactivity of macrophages. Its hallmark is the presence of Michaelis-Guttman bodies. Until the late 1950s, when a case involving the testis was described, the condition was thought to involve only the mucosae of the bladder, ureters, and renal pelvis. The most recent review of malakoplakia of the testis included only 10 known cases.


Ventilatory abnormalities in hospital admissions. The incidence of unrecognised ventilatory impairment was investigated in a group of 531 routine hospital admissions who had been considered to be free of significant respiratory disease. Using spirometric tests of FEV 1, FVC and FEV 1/FVC percent before and after sympathomimetic bronchodilator, it was found that 42 percent of these patients had abnormal ventilatory tests, and 47 percent were considered to have obstructive lung disease. Routine use of screening respiratory function tests would be useful in the assessment and management of general medical and surgical hospital admissions.


Antibiotic resistance of shigellas in New Zealand. A WHO assisted survey of antibiotic resistance of Shigella sp from various countries in the Western Pacific Region was carried out by the National Institute of Health, Tokyo, Japan. Of 282 unselected isolates from throughout New Zealand, 221 (78 percent) exhibited resistance to one or more antibiotics. The implications of these results in relation to treatment are briefly discussed.


Letter: The transient nephrotic syndrome of pregnancy.


The second oncogenic step.

The second oncogenic step. Three theories of the development of a malignant change which each involve two successive steps are described. Armitage, Doll (1957) proposed that two homologous chromosomes each contained a region which was critical in the control of cell division. The two steps were mutations in these regions brought about by random exposure to carcinogenic agents. Comings (1973) proposed a similar theory but the two steps were considered to be spontaneous mutatons. This paper points out that if one mutation has occurred this can become dominant in at least six ways which mostly involve chromosome translocations. The synergism between oncogenic agents and ionizing radiation and the ability to breed out high and low cancer incidence stocks of animals from a common stock can be explained on the same lines.


Chlamydial ophthalmia neonatorum.

Chlamydial ophthalmia neonatorum. A case of chlamydial ophthalmia neonatorum is presented. The importance of early diagnosis and treatment is discussed.


A new tetracycline minocycline compared with ampicillin in general practice. A new tetracycline (minocycline) and ampicillin were compared in the treatment of 217 adults with common infections seen in general practice. Minocycline had an overall clinical effectiveness comparable with ampicillin, though minocycline was more frequently prescribed for suspected staphylococcal infections with satisfactory results in 25 (26). Minocycline was significantly more effective in vitro against common pathogenic organisms than ampicillin. All strains of staphyloccocci isolated were sensitive to minocycline while 15 (27) were resistant to ampicillin. Minocycline and ampicillin were no different in the occurrence of mild side effects. Dizziness was troublesome for 23 (127) patients on minocycline and resulted in four patients discontinuing treatment.


Familial reactive arthritis of Reiter's and ankylosing spondylitis types in the HLA-27 genotype. The close relationship between Reiter's disease and ankylosing spondylitis, which had previously been suspected on the grounds of family and population studies, has been re-emphasised following the recent demonstration of their common close association with the HLA-27 genotype. Nevertheless there are few case reports of both conditions occurring simultaneously in first degree relatives; and documentation of HLA genotype in such families was not generally considered before 1973. Both varieties of reactive arthritis are reported here as occurring in first degree relatives sharing HLA-27 genotype.


Out of hours calls.

Out of hours calls. Approximately 1000 out of hours calls performed by Auckland general practitioners are analysed. These were all general practitioners who personally or by the use of rosters care for their own patients. In a subsequent study it is intended to compare the out of hours work done by a deputising service.


Cast brace application and early ambulation as a treatment of femoral shaft fractures. A report on experience with early cast brace application and ambulation as a treatment for fractures of the femoral shaft is presented. A case for continuing this type of treatment is made.


Dysphagia: caveat oesophagum.

Dysphagia: caveat oesophagum. The seriousness of dysphagia as a symptom is emphasised. Two illustrative cases are described in which carcinoma of the oesophagus causing dysphagia was diagnosed late. The importance of early barium studies and early oesophagoscopy is stressed. The poor results of management of carcinoma of the oesophagus associated with late diagnosis are illustrated in the patient data presented.


Chronic chest wall sinus: an unusual presentation of typhoid. A chronic discharging sinus of the chest wall is described in a 59-year-old Maori woman investigated as a typhoid contact. A heavy growth of Salmonella typhi organisms was cultured from the sinus, which had first appeared 13 years previously.


Alcaligenes faecalis septicaemia.

Alcaligenes faecalis septicaemia. A case of Alcaligenes faecalis septicaemia occurring after appendicectomy is described, and previous reports of this condition are briefly reviewed. Alcaligenes is frequently found in the faeces of healthy people and systemic infections appear to be very uncommon. Nevertheless, if the organism is cultured from the blood it should not be dismissed as a contaminant without careful investigation.


An appraisal of academic pathology and an outline for its reorganisation.


Editorial: Medical research in New Zealand.


Letter: Trends in rheumatic fever.

Letter: Trends in rheumatic fever.


Letter: Infant mortality.

Letter: Infant mortality.


Letter: Central venous cannulation.

Letter: Central venous cannulation.


Letter: Preventing allergies caused by airborne particles.


Good health--the by-product of an untrammelled ethos?


Laboratory measurements in SI units.

Laboratory measurements in SI units.


Ethics of nursing research.

Ethics of nursing research.


After three years.

After three years.


Manpower planning for quality nursing care.


Successful attempt at dissolving stones in the common bile duct.


The veterinary uses of progestagens.

The veterinary uses of progestagens.


Leptospira interrogans serotype pomona infection and leptospiruria in vaccinated pigs.


An orbi-like virus in the faeces of neonatal calves with diarrhoea.


New Zealand national mastitis survey: 1965-6. 2. Measures of mastitis prevalence.


Letter: Experimental production of a staggers syndrome in ruminants by a tremorgenic Penicillium from soil.


Immunity in foot-rot infection.

Immunity in foot-rot infection.


Editorial: Public education.

Editorial: Public education.


Patient-relation panels.

Patient-relation panels.


Editorial: Communication is the name of the game.


Some aspects of Judaism and dentistry.

Some aspects of Judaism and dentistry.


The human face: a focus for multidisciplinary integration.


Macrogenia: a study of treatment results, with surgical recommendations. 1. A retrospective cephalometric study of patients who underwent reduction genioplasties showed large variations in soft-tissue response to osseous reduction. 2. The vertical and horizontal soft-tissue changes coincident to osseous reduction were less than expected. The maximum soft-tissue change observed was approximately 50 per cent that of the hard tissue removed. On the average, the vertical soft-tissue change was about 30 per cent and the horizontal was 25 per cent, when degloving procedures were combined with some form of ostectomy. 3. A considerable length of time is necessary before the soft-tissue changes are stable after reduction genioplasty. In some cases, significant changes occurred up to 8 to 10 months postoperatively. 4. A classification of macrogenia is proposed, based upon a more exact anatomic description of the deformity. 5. On the basis of this classification, the results of the present study, and more recent clinical results, recommendations for the surgical treatment of macrogenia are made.


The epidemiology of Fasciola hepatica infections in sheep on a Lymnaea columella habitat in the Manawatu.


Leptospirosis: New Zealand's no. 1 dairy occupational disease.


Inverted L-shaped ramus osteotomy for prolonged bilateral dislocation of the temporomandibular joint. The various methods of management of prolonged bilateral anterior dislocation of the temporomandibular joints are discussed and the literature is reviewed. Reported is a case in which a bilateral inverted L-shaped ramus osteotomy was performed in order to reposition the mandible and establish normal occlusion; the results were satisfactorily maintained one year postoperatively.


Letter: Elaphostrongylus cervi in red deer.


The use of methylmethacrylate in the fixation of mandibular fractures in dogs. Experimental results. The efficacy of self-curing acrylic resin in the fixation of fractured mandibles was studied in eight adult mongrel dogs. Three dogs were killed at 1 month, two at 3 months, and three at 6 months after insertion of the resin. Roentgenograms taken after operation and after the dogs had been put to death demonstrated satisfactory fracture reduction and bony healing. The retentive grooves appeared larger on the postmortem roentgenograms, apparently from fibrous tissue that formed between the acrylic resin and the bone. Sections through the groove and fracture site did not show any fibrocartilage formation between the bone and the resin. Active osteoblastic activity was present at the fibrous capsule-bone interface as well as in the fracture calluses. Most sections showed acute inflammation, with a few giant cells. Whether the inflammatory component resulted from tissue breakdown over the acrylic resin or from the polymethylmethacrylate itself was not determined. There was no evidence of abnormal healing or nonunion along the fracture line and no evidence of necrotic bone. The undecalcified tetracycline-labeled sections confirmed active bone formation at the fibrous capsule-bone interface and in the fracture calluses at 1, 3, and 6 months. No mobility could be detected across the fracture site at any time after the insertion of the acrylic resin. Two of the three dogs that were killed at 1 month had incomplete bony union, as demonstrated by mobility along the fracture line seen in the resected specimens. Mucosal dehiscence over the superior acrylic fixation bar was a consistent finding. Once the resin had been either exfoliated or removed, the mucosa healed uneventfully. The insertion of methylmethacrylate did not result in blood pressure change in the dogs. The dogs maintained their preoperative weight, appetite, and jaw mobility. Although satisfactory bony healing resulted from the intraoral open reduction and fixation with self-curing acrylic resin in dogs, several factors need additional investigation before this technique can be considered for use in human subjects. The following findings in this study may contribute to healing complications in man: (1) loosening of the acrylic resin due to fibrous tissue formation between it and the bone, (2) mucosal dehiscence, (3) inflammation in and around the fibrous tissue adjacent to the acrylic resin, and (4) the necessity of bone removal to facilitate the insertion of the resin.


Erythema multiforme. Review of twenty-six cases. A survey of twenty-six cases of erythema multiforme was undertaken. All patients had oral lesions and seventeen had skin involvement, mainly on the hands. The average age was 32 years, and female patients predominated in the group. Nearly one third gave a history of a severe emotional disturbance prior to the attack, four patients developed lesions after penicillin therapy, and two presented initially with acute primary herpes simples stomatitis. Skin and mucosal biopsies were undertaken in some patients, and it was concluded that no pathognomonic features were identifiable; a subepithelial bulla, however, could occasionally help in the differential diagnosis. Other laboratory investigations, including a complete blood count, determination of herpesimplex titer, and urinalysis, were not helpful, except that the erythrocyte sedimentation rate was raised in sever cases. Possible etiologic factors were discussed in relation to the survey. It was thought that the cause is still obescure except in drug-induced cases and that the diagnosis is essentially a clinical one, since various laboratory investigations cannot be shown to produce consistent pathognomonic findings.


Allergic stomatitis caused by self-polymerizing resin. This is a fully documented case, including biopsy and patch testing, of a patient who was hypersensitive to self-polymerizing polymethyl methacrylate. On two occasions, a 24-year-old woman with a history of multiple allergies developed allergic reactions to temporary acrylic dental restorations. The lesions disappeared upon removal of the restorations. Microscopic findings were consistent with an allergic reaction. Patch testing confirmed that the allergen was the monomer and indicated methods of processing the self-polymerizing resin to allow it to become essentially nonreactive in a sensitized patient.


Intraosseous angiolipoma of the mandible. A case of intraosseous angiolipoma, one of the rarest benign tumors of bone, is reported. This tumor represents an example of an intraosseous neoplasm consisting of both blood vessels and fat. To our knowledge, such a tumor of the mandible has not been reported previously.


Sweat gland carcinoma of the lips.

Sweat gland carcinoma of the lips. Sweat gland carcinomas are extremely rare tumors with a fully malignant potential. Two cases of primary sweat gland carcinoma of the lips are presented. Because of the unique nature of this lesion, the histopathology and biologic behavior are discussed, and the pertinent literature is reviewed.


Carcinoma arising in the area of median rhomboid glossitis. Routine soft-tissue examination of a 44-year-old Negro woman who consulted her dentist for a new maxillary partial denture revealed a depressed white lesion in the area of median rhomboid glossitis. Biopsy diagnosis of the area was well-differentiated squamous-cell carcinoma. The relation of this lesion to median rhomboid glossitis is questioned in view of previous reports.


The widened periodontal ligament of osteosarcoma of the jaws.


The predentin index.

The predentin index. This is the initial report of a new, objective means of determining early pulpal reaction to an insult. The method consists of (1) direct measurement of the thickness of the predentin in the crown and cervical portions of each tooth, (2) determination of the Predentin Index, and (3) subsequent comparison of the PI's of control versus experimental teeth. If the Predentin Index of the experimental is lower than that of the control, a pulpal injury has occurred. Reliance on the subjective, interpretive ability of the observer is effectively eliminated.


An unusual case of dermatophilosis in a calf.


Misdiagnosis of an impacted supernumerary tooth from a panographic radiograph. A panographic radiograph of a 31-year-old man revealed the presence of an impacted supernumerary paramolar. Periapical radiographs of the same area failed to confirm the existence of this supernumerary tooth. A review of the inherent distortion factors present in panographic radiography leading to the misdiagnosis is discussed.


Letter: Parascaris in foals.

Letter: Parascaris in foals.


Roentgenologic study of the mental foramen. Locating the mental foramen in periapical radiographs is of great clinical importance. One thousand full-mouth intraoral radiographs were examined, and the location of the mental foramen in both the horizontal and the vertical planes was registered. In the horizontal plane 70 per cent of the mental foramina were found to be located between the two premolars, and 22 per cent were in the apical area of the premolars. In the vertical plane the highest percentage of mental foramina was found to be located superior to the level of the apices of the premolars.


Minor salivary gland lesion presenting clinically as tumor.


Dental anatomic anomalies.

Dental anatomic anomalies.


Supernumerary teeth and dentigerous cyst.


Augmentation of the nasomaxillary and nasolabial regions.


The cracked-tooth syndrome and fractured posterior cusp. 1. Even from such a small sample as that reported in this study, it is evident that the fractured cusp and cracked-tooth syndrome are common problems. The large number of fractured cusps compared to the cracked-tooth syndrome suggests that some of the cases of fractured cusp could have been diagnosed earlier. 2. It is most important that dentists be aware of the cracked-tooth syndrome in order to relieve the patient's discomfort, prevent the possible eventual loss of the pulp or tooth, and avoid unnecessary and possibly damaging treatment for misdiagnosed facial pain. 3. Conservation of tooth structure in restorative procedures is most necessary in order to prevent the cracked-tooth syndrome or fractured posterior cusp.


A controlled study of electrosurgical currents and wound healing.


The antilingula as an anatomic landmark in oral surgery. The antilingula is a highly variable anatomic landmark and in most instances is situated considerably anteriorly and superiorly to the inferior dental foramen. However, a cut made between 5 and 10 mm. distal to the antilingula is within a statistically safe area, in over 72 per cent of cases, to avoid encroaching upon the inferior alveolar foramen.


Soft-palate pigmentation in lung disease, including cancer. A study of patients in whom soft-palate pigmentation appeared to be associated with pulmonary disease has been reported. A significant number of these patients had diagnosed or suspected bronchogenic carcinoma. The possibility that this oral finding may be predictive of the presence of lung cancer, or of a high degree of probability of future development of lung cancer, indicates a need for additional investigation. At this point the evidence strongly suggests that when soft-palate pigmentation is seen in a patient with lung disease, cancer should be suspected until it is definitely ruled out. The paucity of patients in whom this sign is seen suggests the need for study by other investigators. ACTH levels should be evaluated, as should plasma zinc values, which have been demonstrated to decrease in lung cancer as well as other diseases. Following the patients prospectively certainly is indicated. In conjunction with the Department of Laboratory Medicine, limited initial additional investigations have been made of the carcinoembryonic antigen (CEA) levels on three of the outpatients reported. These assays used the hemagglutination-inhibition technique and are limited to investigational use by the Food and Drug Administration. In this laboratory the normal CEA level is 5.2 +/- 1.6 ng./ml. Results in two patients with known chronic obstructive pulmonary disease were 5.5 and 5.6 ng./ml. The third patient with soft-palate pigmentation and an undiagnosed pulmonary problem had a CEA level of 10.2 ng./ml. She also had clubbing of the fingers. The senior author would be particularly interested in establishing a registry of similar cases observed by others.


Calcifying odontogenic cysts with intracellular amyloid-like material. Intracellular deposits of amyloid as defined by positive Congo red staining with green polarization birefringence and standardized toluidine blue staining with pink-red polarization birefringence were observed in the epithelial lining of three cases of calcifying odontogenic cysts. It is suggested that this material is not true amyloid but, rather, a dengenerative product of the epithelial cells as has been described in calcifying epithelial odontogenic tumor (Pindborg tumor).


Acute angioneurotic edema of the lips and tongue due to emotional stress. Angioneurotic edema, though a fairly common medical condition, is rarely seen in dental practice. As laryngeal involvement can occur spontaneously and suddenly in the dental office or a similar complication can develop abruptly after administration of certain drugs used in dentistry, an understanding of this condition is definitely indicated. Moreover, as the hereditary form of this clinical entity can be precipitated by trauma, such as various dental and oral surgical procedures with a high incidence of laryngeal edema, an awareness of this phenomenon is an absolute necessity for sound medical and dental practice.


Leakage of different root canal sealants. One hundred five single-rooted teeth were prepared and filled with ten commercially available root canal paste sealers. Five teeth were filled with only gutta-percha points, fifty teeth were filled with a particular cement alone, and the rest of the teeth were filled with a particular cement in conjunction with gutta-percha points. It was found that the gutta-percha point alone is not sufficient for sealing the periapical foramen; nor are N2 (Sargenti), Riebler's paste, and the iodoform paste. In general, it was found that the combination of gutta-percha and cement is more effective in sealing the periapical foramen. Polycarboxylate cement used in this investigation, although it does not meet all the requirements of a good root canal sealant, was found to yield promising results.


Meningioma presenting as an intraoral mass. The following case report illustrates a rather rare oral lesion, an extracranial meningioma. In the dental office the lesion was seen on a periapical x-ray film as a multilocular radiolucency. The patient, however, could not be convinced of the necessity of biopsy until several years later when clinical expansion of the maxillary buccal plate was noted. Thereafter, clinical, radiographic, and histopathologic examination revealed a diffuse meningioma involving the maxillary sinus, the floor of the nose, and the maxillary gingiva. The patient has since refused complete surgical removal but remains alive and well 8 years after the lesion was first noted.


Mucosal ganglioneuromatosis, medullary thyroid carcinoma, and pheochromocytoma: multiple endocrine neoplasia, type 2b. Multiple endocrine neoplasia, type 2b, is a designation that has been proposed for the combination of medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas, and somatic abnormalities. The neural lesions produce a characteristic diffuse or nodular enlargement of lips, tongue, and buccal mucosa. Microscopically, the lesions are composed of unencapsulated masses of hypertrophied and elongated nerves in which are found rare ganglion cells. The histologic similarity between the oral mucosal lesions and the alimentary tract ganglioneuromatosis in the syndrome suggests that the term ganglioneuromatosis is the most appropriate designation for the oral lesions. The oral lesions signal high risk for two potentially lethal neoplasms--medullary thyroid carcinoma and pheochromocytoma. Thus, patients having the characteristic findings are in urgent need of repeated evaluation of thyroidal C-cell and adrenal medullary function.


Television radiographic evaluation of periapical osseous radiolucencies. Periapical lesions were experimentally induced in forty-five teeth of seven beagle dogs by both septic and aseptic techniques. Preoperative and postoperative serial radiographs were produced with a specifically designed animal head x-ray device, at 30-, 60-, and 90-day periods. Four anatomic study areas, which consisted of the cervical, interradicular, proximal root, and periapical areas of each tooth, were evaluated by viewbox observation of radiographs, television subtraction radiographic imagery, and histologic examination. The findings obtained with the subtracted image and histologic examinations were correlated with viewbox observations. Diagnostic evidence of periapical pathosis was identified in the subtracted image 7 to 42 days before this same evidence was noted on the viewbox radiograph. The periodontal membrane space, lamina dura, bone trabeculae, and medullary spaces were markedly enhanced, with defined outlines of the periapical lesions noted in the subtracted image.


The use of iodine as a contrast medium in endodontic therapy. The present study describes the use of 10 per cent iodine in potassium iodide as an intradental x-ray contrast medium in the search for root canals or parts of root canals which were not detected in radiographs or by instrumentation. In most teeth with periapical radiolocencies a passage through the entire root was found by means of the contrast medium, but in the teeth without periapical involvement usually no communication was detected. According to the results of the present study, an intradental contrast medium may be useful in the search for apparently obliterated root canals.


Bilateral postdentition premolars.

Bilateral postdentition premolars.


Japanese tooth positions and their relation to panoramic radiography. 1. Tooth positions did not vary between ages and sexes in Japanese. 2. As the arches lengthened posteriorly, anterior tooth positions showed little variation. 3. Japanese tooth positions lie within the range shown for Caucasoid and Negroid persons. 4. Japanese tooth positions have a shorter anteroposterior dimension than their Caucasoid and Negroid counterparts. 5. The relationships of Japanese positions to the Panorex, Panelipse, and Orthopantomograph are similar to those found for Negroid and Caucasoid persons.


Optical illusion.

Optical illusion.


Foreign body in the nasal fossa.

Foreign body in the nasal fossa.


A quantitative comparison of paralleling long-cone and bisection-of-angle periapical radiography. Quantitative data permit the variability comparison of crown-root ratios computed from periapical films of a single central incisor taken by five technicians using the bisection-of-angle and the paralleling long-cone techniques. The paralleling long-cone technique produces significantly less distortion and is less variable. It is the method of choice for assessing natural root resorption and resorption due to orthodontic therapy.


Fowl plague virus adapted to human leukemia cells: interaction with normal human leukocytes and plastic surfaces. An avian influenza A virus which grows well in human leukemic myeloblasts was unable to replicate in normal human leukocytes. The virus adhered during the first hours of incubation to plastic surfaces and to leukocytes and was then released into the supernatant; care should be taken not to confuse this with viral growth.


Wegener's granulomatosis manifested by 67Ga-citrate scanning.


Computer processing of the scintigraphic image using digital filtering techniques.


Survey of teletherapy in Japan. Part V. State of fractionations in one week.


Uncoupling of local field spectra in nuclear magnetic resonance: determination of atomic positions in solids. Solid state nuclear magnetic resonance as a method of determining crystal structure has had limited success. Three distinct reasons for this failure can be identified when the resonance spectrum is of a dilute spin species in the presence of another abundant species. Two of these difficulties, and in part the third, can be mitigated by a family of coherent averaging techniques in double resonance, with considerably improved prospects for locating the rare spins with respect to their nearby neighbors. A particularly advantageous procedure is described and possible applications are discussed.


2-diazo-3,3,3-trifluoropropionyl chloride: reagent for photoaffinity labeling. 2-Diazo-3,3,3-trifluoropropionyl chloride has been synthesized from trifluorodiazoethane and phosgene. Its derivatives are acid stable, can be used to label enzymes, and undergo photolysis with substantially less rearrangement than do derivatives of other known diazoacyl reagents designed for photoaffinity labeling. In particular, the diazotrifluoropropionyl thioester of methyl N-acetylcysteine undergoes photolysis in methanol with about 40% insertion into the - OH bond of the solvent; by contrast, photolysis of other diazoacyl thioesters gives substantially quantitative Wolff rearrangement. The trifluoro compounds hold promise for the photoaffinity labeling of thiols.


Elucidation of hydrocarbon structure in an enzyme-catalyzed benzo[a]pyrene-poly (G) covalent complex. The carcinogen, benzo[a]pyrene, was covalently attached to poly (G) by liver microsomes from rats pretreated with 3-methylcholanthrene. The complex was hydrolyzed with enzymes or base and products were isolated by Sephadex chromatography. Absorbance and fluorescence spectra of the products fit that of red-shifted pyrene aromatic system and suggest that metabolism has occurred at the 7-, 8-, 9-, and 10-positions of the hydrocarbon. Benzanthracene or chrysene fluorescence were not observed in these preparations. Benzo[a]pyrene derivatives were synthesized and purified by high-pressure liquid chromatography. Dehydration of 7,8-dihydroxy-7,8,9,10-tetrahydrobenzo[a]pyrene resulted in the formation of small amounts of 7-oxo-7,8,9,10-tetrahydrobenzoa[a]pyrene. A 7-keto species was also observed after similar treatment of the hydrocarbon-poly(G) hydrolysis products. Evidence of dehydration at the 9,10-positions was not observed. The hydrocarbon covalently bound to poly(G) is, therefore, a derivative of 7,8-dihydroxy-7,8,9,10-tetrahydrobenzol[a]pyrene with nucleic acid substitution at C-10 or 9.


Comparative study of alkaline phosphatase activity in lymphocytes, mitogen-induced blasts, lymphoblastoid cell lines, acute myeloid leukemia, and chronic lymphatic leukemia cells. Alkaline phosphatase [orthophosphoricmonoester phosphohydrolase (alkaline pH optimum), EC 3.1.3.1] purified from a Burkitt lymphoma cell line (Daudi) and Moloney-virus-induced murine leukemia (YAC) showed unique catalytic properties in substrate specificity and inhibition by cysteamine-S-phosphate. It migrated on polyacrylamide gel electrophoresis in a single activity band. Alkaline phosphatase with similar properties was found in several human lymphoblastoid cell lines, in chronic lymphatic leukemic cells, in organs of leukemic mice, and in sera of patients with certain lymphoproliferative disorders.


On the obligatory role of the hypophysis in sexual differentiation hepatic metabolism in rats. The hepatic metabolism of 4-[4-14C]androstene-3,17-dione and 5alpha-[4-14C]androstane-3alpha,17beta-diol was studies in castrated and hypophysectomized male rats with a transplanted pituitary under the kidney capsule. The effects of testosterone propionate and estradiol benzoate on liver metabolism were also studied in these experimental animals. It was found that the autonomous pituitary secreted a "feminizing factor" that transformed the male type of steroid metabolism characteristic of hypophysectomized rats into a female type of metabolism Hypophysectomized rats were unresponsive towards androgen action on the liver and did not respond with feminized hepatic metabolism after treatment with estradiol benzoate. It is concluded that estrogenic action on liver enzymes is mediated via modulation of the secretion of a central (probably hypothalamic) "feminizing factor inhibiting factor" and the sex hormonal effects of hepatic metabolism only occur in the presence of a pituitary in situ.


Induction of vitellogenin synthesis by estrogen in avian liver: relationship between level of vitellogenin mRNA and vitellogenin synthesis. We have investigated the estrogen-mediated induction of vitellogenin synthesis in rooster liver. We compared the concentrations of vitellogenin messenger RNA (mRNA) in the liver with the concentrations of vitellogenin in the sera of roosters that had recieved various treatments with estrogen. We found no vitellogenin mRNA in the livers of the unstimulated roosters. An initial injection of estrogen was attended by de novo synthesis of vitellogenin mRNA in the liver and accumulation of vitellogenin in the serum. When vitellogenin was no longer present in the serum or liver (the "post-estrogen-serum-negative" state), the liver was found to contain appreciable amounts of vitellogenin mRNA. This mRNA was of the same size as that found in the liver of the rooster actively synthesizing vitellogenin in response to estrogen. Whereas vitellogenin mRNA was in large polysomes in the livers of the roosters actively synthesizing vitellogenin, the vitellogenin mRNA in the liver of the post-estrogen-serum-negative rooster was not associated with polysomes. The possible relevance of these findings to the fact that the rooster responds differently to a primary stimulation with estrogen than to subsequent stimulations is discussed.


Characterization of a gamma-carboxyglutamic acid-containing protein from bone. A gamma-carboxyglutamic acid-containing protein has been purified from the calcified tissues of several vertebrates. The presence of three-gamma-carboxyglutamic acid residues in the bovine protein was established by alkaline hydrolysis and amino acid analysis, a method based upon studies with synthetic gamma-carboxyglutamic acid. The identity of gamma-carboxyglutamic acid in the bovine protein was established by mass spectroscopy on the unknown amino acid isolated from alkaline hydrolysates.


Synthesis of nuclear proteins during DNA repair synthesis in human diploid fibroblasts damaged with ultraviolet radiation of N-acetoxy-2-acetylaminofluroene. We have examined the accumulation of newly synthesized nuclear proteins into nuclei during DNA repair synthesis in confluent WI-38 human diploid fibroblasts damaged with ultraviolet radiation or N-acetoxy-2-acetylaminofluroene. In contrast to a marked stimulation of DNA repair synthesis, stimulation of amino acid incorporation into histone polypeptides or into the various molecular weight classes of nonhistone nuclear proteins was not observed. These results suggest that detectable stimulation of newly synthesized nuclear protein incorporation into nuclei does not accompany DNA repair synthesis induced by ultraviolet radiation or a direct acting chemical carcinogen. At least for the special case of repair, DNA synthesis may be uncoupled from histone synthesis.


Biological consequences of incorporation of 5-fluorocytidine in the RNA of 5-fluorouracil-treated eukaryotic cells. Treatment of HeLa cells with 5-fluoro-[3H]uracil leads to the incorporation into cellular RNA of 5-fluorocytidine to the extent of about 0.2% of the 5-fluorouridine incorporated. In tobacco mosaic virus RNA produced in tobacco leaves this ratio is one order of magnitude lower. Copolymers of cytidylic with 5-fluorocytidylic acids show unchanged template activity with E. coli RNA polymerase, but slightly altered messenger activity in the wheat germ system, compared to poly(C), and it is suggested that some of the biological consequences of 5-fluorouracil treatment of living cells and organisms may be attributed to this mechanism.


In vitro transcription of chromatin in the presence of a mercurated nucleotide. Mercurated uridine triphosphate has been used to label transcripts of chicken reticulocyte chromatin made with Escherichia coli RNA polymerase. The mercury-labeled RNA product can be completely separated from endogenous RNA sequences in the chromatin by passage through a sulfhydryl Sepharose column. Globin cDNA hybridization to the transcript shows that only 2.6 x 10-5 of the transcript is globin RNA. In contrast to this result, erythrocte chromatin transcript contains less than one tenth as many globin RNA sequences.


Presence of messenger specifying sequences in the DNA of chromatin subunits. Messenger-specifying sequences in subunits of human lymphocyte chromatin were detected by hybridization of DNA complementary to cytoplasmic polyadenylylated RNA with DNA isolated from the subunits. Comparison of the kinetics and extents of hybridization of complementary DNA with chromatin subunit DNA and with nuclear DNA showed that most of the repetitive sequences and single copy sequences in mRNA are present in chromatin subunits. This result indicates that inclusion of a DNA sequence into the subunit does not prevent its transcription in vivo.


A protein binding the methylated 5'-terminal sequence, m7GpppN, of eukaryotic messenger RNA. Ribosomal salt washes of Artemia salina embryos contain a protein(s) that binds [3H]m7GpppGpC and [3H]m7GpppGmpC, as measured by retention on nitrocellulose membrane filters. These oligonucleotides correspond in structure to the methylated 5'-terminal sequences (caps) present in many eukaryotic mRNAs. The cap binding protein does not bind the unmethylated counterparts of caps, e.g., [32P]GpppGpCp, or a derivative of m7GpppGmpC containing ring-opened m7G. None of the purified initiation factors IF-MP, IF-M2A, IF-M2B, IF-M3, or IF-MI binds the m7G-containing oligonucleotides.


Long-chain neutral glycolipids and gangliosides of murine fibroblast lines and their low- and high-tumourigenic hybrids. The patterns of long-chain neutral glycolipids and gangliosides of established, L-cell-derived murine fibroblast lines and their low- and high-tumorigenic hybrids were studied.


Ability of insulin to increase calcium binding by adipocyte plasma membranes. Calcium specifically binds to adipocyte plasma membranes, demonstrating two classes of binding sites having affinity constants of 4.5 x 10(4) M-1 and 2.0 x 10(3) M-1. Insulin (100 microunits/ml) added directly to the isolated plasma membranes caused no alteration in calcium binding, whereas incubation of the adipocytes with 100 microunits/ml of insulin resulted in a 2.50 +/- 1.6% increase in calcium binding to the subsequently isolated plasma membranes. The increase in calcium binding produced by insulin resulted from an increase in the maximum binding capacities of both classes of binding sites without alteration in their affinity constants. Additionally, a second pool of calcium in adipocyte plasma membranes has been identified by atomic absorption analysis; it was more than two times larger than the maximum binding capacity of the calcium binding system. This pool of calcium was stable, did not participate in the 45Ca2+ exchange, and was unaltered by insulin treatment. A simialr stable pool of magnesium exists in plasma membranes and was also unaffected by insulin treatment. The increased capacity of the isolated plasma membranes to bind calcium after insulin treatment of the cells may represent an important bioregulating mechanism and supports the concept that calcium may play an important role in the effector system for insulin.


Hepatic phenylalanine 4-monooxygenase is a phosphoprotein. Phenylalanine hydroxylase [phenylalanine 4-monooxygenase; EC 1.14.16.1; L-phenylalanine, tetrahydropteridine:oxygen oxidoreductase(4-hydroxylating)] isolated from rat liver is a phosphoprotein containing approximately 0.31 mumol of  protein-bound phosphate per mumol of subunit (50,000 molecular weight). When the enzyme is further phosphorylated in the presence of ATP and a 3'5'-cyclic-AMP-dependent protein kinase (EC 2.7.1.37; ATP:protein phsophotransferase), an additional 0.7 mumol of phosphate per mumol of subunit is introduced, bringing the total phosphate content up to about 1 mumol/mumol of subunit. This phosphorylation of the enzyme in vitro is accompanied by a 2.6-fold increase in hydroxylase activity when the activity is assayed in the presence of tetrahydrobiopterin. Partial proteolytic digestion of phenylalanine hydroxylase, which previously had been shown to activate the enzyme 20- to 50-fold [Fisher, D.B. & Kaufman, S. (1973) J. Biol. Chem. 248, 4345-4353], removes almost all of the phosphate from the enzyme.


Nuclear magnetic resonance study of heme-heme interaction in hemoglobin M Milwaukee: implications concerning the mechanism of cooperative ligand binding in normal hemoglobin. Hemoglobin M Milwaukee (beta 67E11 val leads to Glu) is a naturally occurring valency hybrid containing two permanently oxidized hemes in the beta-chains. In this mutant, the two abnormal beta-chains cannot combine with oxygen, whereas the two alpha-chains are normal and can combine with oxygen cooperatively with a Hill coefficient of approximately 1.3. High-resolution proton nuclear magnetic resonance spectroscopy at 250 MHz has been used to investigate the hyperfine shifted resonances of the abnormal ferric beta-chains of Hb M Milwaukee over the spectral region from -30 to -60 parts per million from water at pD 7 and 30 degrees.


Inelastic electron tunneling spectroscopy of nucleic acid derivatives. Inelastic electron tunneling spectra of nucleosides and nucleotides are presented which show that detailed information on the vibrational spectra of these molecules can be obtained from a few micrograms of material. A series of studies on adenine derivatives demonstrates that unambiguous identification of a large number of slightly different derivatives can be carried out by means of this technique.


An enzyme system for replication of duplex circular DNA: the replicative form of phage phi X174. Viral single strands (SS) are converted to the duplex from (RF) by a soluble enzyme fraction uninfected Escherichia coli [Schekman et al. (1975) J. Biol. Chem. 250, 5859-5865]. When reactions were supplemented with a soluble enzyme fraction from phi X174-infected cells, replication of phi X174 superhelical RF I DNA was observed. The activity supplied by infected cells was absent in cells treated with chloramphenicol or in cells infected with a phi X174 phage mutant in cistron A (cis A). A host function coded by the rep gene, essential in vivo for RF replication (but not for SS leads to RF), was supplied by enzyme fractions from either infected or uninfected cells. Based on complementation assays, the cisA-dependent and the rep-dependent proteins have each been purified about 1000-fold. The synthetic products of the enzymatic reaction were identified as RF I and RF II in which viral (+) and complementary (-) strands were newly synthesized.


Cell cycle analysis and X-chromosome inactivation in the developing mouse. The duration of different phases of the cell cycle (G1, S, G2, and M), as well as the exact time of initiation of asynchronous DNA replication pattern in one of the X-chromosomes in the female mouse during the early stages of development, have been investigated. It was found that early developmental stages in the mouse are devoid of G1 period, and from the late blastocyst stage the embryonic cells first acquire all the characteristic stages of the cell cycle (G1, S, G2, and M). Additionally, asynchronous DNA replication pattern in one of the X-chromosomes in the female embryos was found to be initiated with the appearance of the G1 period. I have established a correlation between the onset of the G1 period and the initiation of an asynchronous DNA replication pattern in one of the X-chromosomes of the female mammal during embryogenesis.


An evaluation of messenger RNA competition in the shutoff of human interferon production. The process that shuts off poly(I)-poly(C)-induced interferon production in a strain of diploid human fibroblasts (FS-4)-involves the synthesis of new RNA, presumably nuclear heterogeneous RNA. When cultures in the shutoff phase of interferon production are treated with actinomycin D (5 mug/ml) or 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazole (DRB 40 muM), the rate of interferon production continues to decline for a further 3-4 hr, but then tends to level off. The treated cultures maintain interferon production at a reduced level for at least 10 hr. The residual rate of interferon production is higher in cultures which received actinomycin D or DRB early in the shutoff phase as compared to the rate in cultures treated late.


Stimulation of prostaglandin E synthesis in cultured human umbilical vein smooth muscle cells. Cultured human umbilical vein smooth muscle cells secreted 1.26 +/- 0.20 mug of immunoreactive prostaglandin E (iPGE) per mg of cell protein per 24 hr (mean +/- SEM). In indomethacin, an inhibitor of prostaglandin synthesis, abolished greater than 95% of this basal iPGE production (ID50 = 1.8 nM).


Fluidity in mitochondrial membranes: thermotropic lateral translational motion of intramembrane particles. The fracture faces of frozen rat liver mitochondria reveal that intramembrane particles can be induced to under go long-range lateral translational motion and aggregation, which parallel the appearance of large, particle-free smooth patches in the hydrophobic interior of the two mitochondrial membranes. These lateral separations were observed under conditions that induce thermotropic lipid-lipid phase separations. Low temperature-induced lateral separation occurred between the intramembrane particles (integral proteins) and smooth patches (bilayer lipid) at temperatures between about 10 and -12 degrees in the outer membrane and between about -4 and -12 degrees in the inner, energy transducing membrane.


Alpha-methyl ornithine, a potent competitive inhibitor of ornithine decarboxylase, blocks proliferation of rat hepatoma cells in culture. A biphasic increase of putrescine concentration occurs in rat hepatoma tissue culture cells induced to proliferate. DL-alpha-Methyl ornithine, a competitive inhibitor of ornithine decarboxylase ( L-ornithine carboxylyase, EC 4.1.1.7) of hepatoma tissue culture cells, blocks the usual increases of putrescine and spermidine concentrations in these cells, and causes a rapid fall in the levels of putrescine which is followed by a striking decrease of spermidine. In parallel with the depletion of these amines, incorporation of [3H]thymidine into DNA and cell proliferation are inhibited. Addition of putrescine, spermidine, or spermine results in an immediate resumption of cell proliferation. Cell proliferation is also restored by L-ornithine presumably due to in situ competitive inhibition of ornithine decarboxylase. These findings of hepatoma tissue culture cells support the concept that polyamines play an essential function in the cell division processes.


The development of the action potential mechanism of amphibian neurons isolated in culture. Nerve and muscle cells differentiated morphologically, in cultures of dissociated cells prepared from amphibian neural plate and underlying mesoderm (Xenopus laevis, Nieuwkoop and Faber stage 15). Cultures were grown in a defined medium containing sterile Steinberg's salt solution and 0.1% bovine serum albumin, and maintained for periods up to 5 days.


Different calcium requirements for proliferation of conditionally and unconditionally tumorigenic mouse cells. Conditionally tumorigenic BALB/3T3 mouse cells (which produce tumors in BALB/c mice only under special conditions) cannot sustain DNA synthesis and consequently stop proliferating in media containing low concentrations (0-0.02 mM) of physiologically available calcium. By contrast, cells that have been neoplastically transformed (tumorigenic in mice without special assistance) in vitro by different oncogens, can sustain DNA synthesis and proliferate in such calcium-deficient media. The possible importance for tumor growth of an ability to withstand calcium deprivation is examined. It is suggested that this property may prove to be a reliable indicator of neoplastic transformation.


Distribution of annionic sites in glomerular basement membranes: their possible role in filtration and attachment. Lysozyme (pI = II) has been used to identify anionic sites in the glomerular capillary wall. A solution of 1-3% lysozyme was perfused into the left kidney at varying rates. After perfusion, the kidney was fixed in situ and processed for electron microscopy. Lysozyme was seen as an electron-dense deposit which was not present when succinylated lysozyme (pI = 4.5) or myoglobin (pI = 6.9) was perfused instead of native lysozyme. First, the epithelial cell plasma membrane was outlined by a 300-400 A electron-dense layer. Second, there were discrete dense deposits in the subepithelial portions (lamina rara externa) of the basement membrane which, in normal sections, extended from the epithelial cell membrane to the lamina densa and, in grazing section, formed a continuous reticular pattern.


Multiple active forms of thrombin: binding to platelets and effects on platelet function. The effect of various forms of thrombin on certain platelet functions has been investigated. Partially purified bovine thrombin which is a mixture of multiple active forms of thrombin, was chromatographed to yield molecular species termed alpha-, beta-, and gamma-thrombin, each of which has varying degrees of fibrinogen clotting and esterase activities. A direct correlation was observed between the ability of the different forms of thrombin to clot fibrinogen and to influence platelet function. In general, thrombin with high fibrinogen clotting activity was also a potent inducer of platelet aggregation and the release reaction, while those species with low clotting ability were poor inducers of aggregation and release.


Evolution of continuous variation: direct approach through joint distribution of genotypes and phenotypes. The evolutionary dynamics of the joint distribution of genotypes and phenotypes is studied. The model, originally devised to study the joint effects of Mendelian and other types of transmissions, provides results of interest also to the theory of direct Mendelian transmission with natural selection. Assuming bivariate normal distributions, it is shown that in the latter case genotypic and phenotypic means and variances, and genotype-phenotype correlation can be expressed recursively as functions of the parameters for the selection, environmental, and mutation variance. Equilibria and rates of approach for these moments are calculated. It is also proved that in the presence of selection the heritability,defined as the ratio of expected genotypic to expected phenotypic variance after selection, is greater than that before selection by a predictable amount and that it can be greater than unity.


Changes in type of collagen synthesized as clones of chick chondrocytes grow and eventually lose division capacity. Clones of embryonic chick chondrocytes have been isolated and collagen biosynthesis has been followed as the clones grow and eventually lose division capacity. Analysis of collagen type at each successive subculture until the time of cellular senescence has shown that a change in synthesis occurs from the cartilage-specific Type II collagen (chain composition [alpha1(II)]3) to a mixture of Type I collagen (chain composition [alpha1(I)2alpha2) and the Type I trimer (chain composition[alpha1(I)]3). The results demonstrate unequivocally that the expression of the chick chondrocyte phenotype is unstable in vitro, and that previous experiments with mass cultures of chondrocytes cannot be accounted for by overgrowth of fibroblasts. Since similar morphological changes and a similar "switching" in collagen biosynthesis have been observed after growth of chondrocytes for a few days in 5-bromo-2'-deoxyuridine, it is proposed that growth in this analog accelerates those changes that eventually lead to cellular senescence.


Hypersensitivity to tobacco antigen.

Hypersensitivity to tobacco antigen. A glycoprotein of molecular weight 18,000 was purified from saline extracts of cured tobacco leaves by ammonium sulfate fractionation, chromatography on Sephadex G-25 and continuous-flow preparative electrophoresis on polyacrylamide gel. Twelve of 31 volunteers (6/15 smokers and 6/16 nonsmokers) exhibited immediate cutaneous hypersensitivity (wheal and flare reactions) when injected intracutaneously with 2 mug of this material. Immunochemically similar material was demonstrated in, and purified from, cigarette smoke condensate and cigarette smoke. The concentration in cigarette smoke condensate ("tar") was determined to be 1.8-3.6 mg/g. Antigenically crossreactive material was also demonstrated in eggplants, green peppers, potatoes, and tomatoes, which, like tobacco, are members of the family Solanaceae.


The effect of main artery occlusion of one kidney on blood pressure of dogs. Occluding the main artery of one kidney in each of six dogs resulted in an average increase in the renin concentration of the peripheral blood from the original 0.040 to 0.198 milliunit/ml of serum. During the same time (3-4 days), the occlusion also resulted in a significant rise of directly measured mean systemic blood pressure from an average basal level of 104 to 139 mm Hg.


Inhibition of arachidonic acid release from cells as the biochemical action of anti-inflammatory corticosteroids. Serum stimulates the production of prostaglandins by transformed mouse fibroblasts. Hydrocortisone (cortisol) inhibits this stimulation. The half-maximal inhibition occurs at 6x10-9 M. Studies with cells labeled with [3H]arachidonic acid in their lipids show that the stimulation by serum results in the release of arachidonic acid from the cellular lipids, mostly phospholipids. Hydrocrotisone inhibits this release but does not inhibit the production of prostaglandins from exogenously supplied arachidonic acid. This inhibition of arachidonic acid release from phospholipids may be the mechanism for the anti-inflammatory action of corticosteroids.


Analysis of ion distribution in subcellular myocardial particulates separated by density gradient centrifugation with nonpolar liquid under ion immobilization conditions. Methods have been developed for the measurement of the Ca and Mg contents of subcellular particulates, separated by nonpolar liquid density gradient ultracentrifugation. After rapid deep freezing and removal of water by freeze-drying the frozen crushed tissue, homogenization and sonification a nonpolar liquid were carried out. Application of this technique has yielded evidence that the relative amounts of Mg and Ca are greatly different in the several subcellular particulates of normal heart muscle separated by density gradient centrifugation. It also appears that the comparative specific activity of Ca, after loading the perfusates with 45Ca, is very different in the several density fractions of the normal heart. The density site of greatest loading with 45Ca is changed in Ca2+-lack arrest and is very greatly altered by the induction of paradoxical Ca contracture. The method of ion-immobilization separation for water-free particulates of different densities in nonpolar liquids appears to be applicable to analysis for various constituents of other biological materials.


Kinetics of glucagon in man: effects of starvation. Serum stimulates the production of prostaglandins by transformed mouse fibroblasts. Hydrocortisone (cortisol) inhibits this stimulation. The half-maximal inhibition occurs at 6x10-9 M. Studies with cells labeled with [3H]arachidonic acid in their lipids show that the stimulation by serum results in the release of arachidonic acid from the cellular lipids, mostly phospholipids. Hydrocortisone inhibits this release but does not inhibit the production of prostaglandins from exogenously supplied arachidonic acid. This inhibition of arachidonic acid release from phospholipids may be the mechanism for the anti-inflammatory action of corticosteroids.


Replication of mycoplasmavirus MVL51: attachment of MVL51 parental DNA to host cell membrane. The replication of the single-stranded circular DNA of MVL51 mycoplasmavirus has been studied with respect to the roles of free and membrane-associated viral DNA intermediates. Replication involves the formation of parental replicative intermediate (RF) molecules on, at most, two to three membrane sites per cell, symmetric RF replication at the membrane and apparent asymmetric RF replication in the cytoplasm leading to single-stranded progeny chromosomes.


Apolipoproteins in rat serum and renal lymph. The concentration of apolipoproteins was measured by quantitative immunoelectrophoresis in rat serum, in the lipoprotein-free ultracentrifugal fraction (density greater than 1.21) of serum, and in renal lymph. The A-IV and arginine-rich apolipoproteins were present in high concentrations (greater than 18.5% of serum concentration)  both in the fraction of density greater than 1.21 and in renal lymph, whereas the other apolipoproteins were found in low concentrations ( less than 7% of serum concentration). The major apolipoproteins of renal lymph were similar to those found in the fraction of density greater than 1.21; however, the apolipoproteins composition of the renal lymph was very different from the apolipoprotein composition of serum lipoproteins. The presence of certain apolipoproteins in the fraction of density greater than 1.21 and in renal lymph suggests that these apolipoproteins might be present in the circulation as "free" apolipoproteins. The possible physiological importance of these specific apolipoproteins is postulated.


Alterations in ingestive behaviors after bilateral lesions of the amygdala in the rat.


Effects of cholera toxin on cochlear endolymph production: model for endolymphatic hydrops. To evaluate a possible role for adenylate cyclase [ATP pyrophosphate-lyase (cyclizing), EC 4.6.1.1] and adenosine 3':5'-cyclic monophosphate in the secretion of endolymph, we studied the effect of an intra-scala media injection of purified cholera toxin (an adenylate cyclase stimulant) on cochlear endolymph volume, endolymphatic potential, and endolymphatic Na and K concentrations.


Immediate response to expiratory threshold load. In anesthetized rabbits, cats and dogs the end-inspiratory volume referred to normal FRC (deltaVe.i.) of the first breath during expiratory threshold load (ETL) was greater than control deltaVe.i. The increase of deltaVe.i. was roughly proportional to the increase of end-expiratory volume relative to normal FRC (deltaVe.e.) caused by ETL. During squeezing of the rib cage or of the abdomen or after cordotomy at T1 the phenomenon occurred nearly to the same extent. This suggests that afferent impulses from the chest wall are not essential in determining the phenomenon. The first inspiration during ETL occurred after a delay that was roughly proportional to the increase of deltaVe.e: the arterial Pco2, however, was not significantly increased at the time of the first inspiration during ETL. After bilateral vagotomy the first inspiration during ETL was no longer increased. An explantation of the increased deltaVe.i. of the first inspiration during ETL is provided on the basis of the vagal dependent tidal volume-inspiratory duration characteristic of the respiratory center.


Brown Medical School and the Rhode Island community--an arrangement of mutual benefit?


Brown University program in medicine, class of 1976: some biographical observations.


A radiographic study of mineralization of permanent teeth in a group of children aged 3-7 years. The purpose of the present study was, by using a standardized radiographic technique, to assess the time of selected mineralization stages of all permanent teeth except the second and third molars in a group of 580 children aged 3-7 years. A complete radiographic examination, consisting of nine intraoral films, was made of each child, using Eggen's film holder. According to degree, mineralization of the teeth was subdivided into nine stages. The cap relation between the two variables, mineralization stage and chronologic age, was calculated by linear regression analysis. The hypothesis of the present study, that linearity exists between the two variables, was confirmed within and close to the investigated age group.


Prevalence of gingivitis among children with and without school dental service. In order to evaluate the effect of school dental care on the prevalence of gingivitis in children, two groups of children in the 7th grade (approx. age 13-14 years) were compared, only one of the groups having had school dental service. A  total of 758 children from eight different provincial towns in Denmark were studied. Gingivitis was recorded by the method of Löe & Silness. The results are given as the average sum of sound, inflamed, and severely inflamed gingival zones and in frequency tables. There were only small differences between those children who had had school dental service and those who had never received it.


Developmental disturbances in permanent teeth after intrusion of their primary predecessors. The frequency and type of developmental disturbances in the permanent teeth in relation to the child's age at the time of injury were examined in 78 patients with 100 intruded primary incisors. The central incisors were found to be the most frequently affected teeth. Only maxillary teeth were involved. The dominating age group was 1-3 years and intrusion was seldom seen after the age of 4 years. The frequency of disturbed normal development of the permanent teeth was 54%. In eight cases the intruded teeth were removed immediately, 86 teeth reerupted, and six teeth did not reerupt. Internal white enamel hypoplasia was seen frequently; external hypoplasia, seldom.


Size of nucleus and nucleolus in quantitative electron microscopy on orthokeratinized leukoplakias. Eleven leukoplakias of the homogeneous orthokeratotic type and control areas in the same patient were studied by means of standardized electron microscopic preparations of biopsy material and by methods of stereology applied to electron micrographs. In leukoplakias, nuclei and nucleoli were consistently enlarged at three epithelial levels, nucleoli in the basal cells averaging twice the control size. Comparison with specimens of mucosa of the hard palate showed that the enlargement of nuclei and nucleoli in orthokeratinized leukoplakias was in excess of the normal size differential between inherently orthokeratinized and nonkeratinized regions of the human oral mucosa. This suggests an abnormal stimulation of protein-synthetic activity even in this prognositcally "benign" type of leukoplakia.


The occlusal fissure of unerupted third molars as an experimental caries model in man. The aim of the present investigation was to establish an experimental model for the study of fissure caries development under conditions as similar as possible to the in vivo situation. Twenty-one blocks (2 X 2 X 3 mm) constituting part of the occlusal fissure were made from unerupted human third molars, and implanted for 60 or 90 d in mandibular molars of students. One milliliter of a 50% sucrose solution was applied to the fissures twice a day. After removal, sections were examined microradiographically in polarized light and in the electron microscope. As a control, the morphology and enamel structure of fissures from 10 unerupted third molars were studied. After 90 d a subsurface, radiolucent caries-like lesion was observed in two specimens only. When examined in air in polarized light, however, all sections exhibited caries-like lesions symmetrically located around the fissures. The 60-d material showed similar lesions, but not as frequently as the 90-d specimens. In the experimental material processed for electron microscopy revealed that the fissure plaque mainly consisted of cocci and small rods. Most often the bacteria were separated from the enamel surface by a pellicle.


A new method of recording the elastic recovery of dental impression materials. Assessments of the elastic recovery of elastic impression materials have so far been carried out only to a limited degree because of lack of adequate measuring instruments. A method is described which enables measurement and recording electronically of the creep properties, including the elastic recovery time and the permanent deformation, of elastic impression materials in relation to their degree of setting and to the size and time of the induced deformation. The apparatus and the experimental and mathematical methods described can easily be handled by a reasonably skillful laboratory assistant.


Autoradiography of 99Mo in developing rat teeth and bone. Four littermate, 8-day-old rats were given intraperitoneal injections of 99Mo and sacrificed at 1, 4, 24, and 96 h. Autoradiography of whole-body freeze-dried sections was carried out to study distribution of the tracer, particularly in bones and teeth. The tracer was rapidly cleared from the soft tissues except for the kidney and urinary bladder. Uptake in growing bone was moderate and relatively transient. The dentin showed moderate uptake, but enamel in the final mineralization phase showed the most intense concentrations of 99Mo of all mineralized tissue. The tracer did not appear in the pulp, enamel organ, or early enamel matrix.


Phases in preamalgamated silver amalgam alloy. The phase content of six preamalgamated alloys available on the dental market has been determined by means of X-ray diffraction. The beta 1-phase was found in five alloys.


Survival among patients with liver metastases from cancer of the colon and rectum. Factors influencing spontaneous survival in 49 patients with liver metastases after cancer in colon/rectum were evaluated. In addition the same evaluation was performed in 12 patients treated with 5-Fluoro-uracil systemically of intraarterially in the hepatic artery. Alkaline phosphatases, elevated more than 4 times normal values, elevated serum alanine aminotransferase, or jaundice are all unfavorable prognostic signs in the spontaneous group. In the 5-Fluoro-uracil treated group only elevated serum dilirubin had the same unfavorable prognostic sign. Even though it seems to be an increased survival time in the 5-Fluoro-uracil treated group it is concluded that metastases to the liver from cancer in colon/rectum assume to be more or less resistent to 5-Fluoro-uracil.


Early complications in patients previously treated with corticosteroids. A retrospective analysis is presented is presented of 205 major operations performed over a 10-year period on 95 previously steroid-treated patients with Crohn's disease (C.D.) or ulcerative colitis (U.C.). All patients had been treated both in the medical and in the surgical gastroenterological department. The incidence of early postoperative complications was high, but there was nothing to suggest a relationship between the complications and the intensity of the preoperative steroid therapy. However, mortality rate, duration of hospital convalescence as well as incidence of complications were found to be significantly lower in those patients who had undergone elective in preference to emergency surgery. The fear of an increased complication rate following intensive steroid treatment of patients with acute C.D. or U.C. is, in our opinion, unfounded.


Postoperative mortality and complications after colectomy for ulcerative colitis. During a 10-year period colectomy was performed on 101 patients. The postoperative mortality of 12 per cent was influenced decisively by duration and severity of the disease. Seventy-eight per cent of the patients were severly ill during the attack leading to colectomy, and 15 per cent of them died. One-third of the patients with toxic megacolon and general intoxication died. One-quarter of the patients with a history of less than 3 months died. The causes of death were peritonitis and pulmonary complications. Half of the patients developed postoperative complications of varying severity. Preoperative steroid medication did not influence the mortality or the postoperative complications. It is concluded that only close medical and surgical cooperation, careful selection of patients, and skillful timing of operations may reduce the mortality in ulcerative colitis. The paper supports that total colectomy in suitable cases may be performed without higher mortality than subtotal colectomy.


Penetration of penicillin into laparotomy wounds to reduce bacterial contamination during intestinal operations. Serum and tissue specimens from the surgical wound were taken simultaneously during colo-rectal operations (i) at the start, (ii) when entering the peritoneal cavity, (iii) during bowel procedures and (iv) before closure of the wound. A dose of 5 megaunits penicillin intravenously after incision gave a median serum concentration of 140.0 IU/ml and a tissue concentration of 33.8 IU/mg at the time the peritoneum was incised. During operation the concentration in serum fell significantly, being 18.5 IU/ml after more than 3 h of operation, while that in wound tissue decreased to 7.2 IU/mg. After concentration was 16.0 IU/ml in serum and 1.9 IU/mg in wound tissue at the time of incision and when entering the peritoneal cavity; thereafter the concentrations decreased with operation time. The concentrations in serum exceeded markedly those in wound tissue, being linearly correlated throughout operation. Only the intravenous bolus produced concentrations of penicillin antibacterial to a variety of aerobic organisms.


Route of infection in extrahepatic biliary tract disease. II: Bacterial recovery from gallbladder bile and gallbladder wall in human biliary tract disease. Bacterial recovery from gallbladder wall and gallbladder bile was investigated in 73 patients with extrahepatic biliary tract diseases. The technique of anaerobic culture was based on the use of a 'glove-box' and prereduced anaerobically sterilized media. Transport of samples was based on evacuation of atmospheric air with oxygen-free carbon dioxide and a transport time less than 30 minutes. When samples of bile and tissue were obtained simultaneously before operations on the biliary tract were begun and handled by one of the authors to avoid contamination, no significant difference in bacterial recovery between bile and tissue was observed. If samples were handled routinely by the staff or if biopsy from the gallbladder wall was not obtained until after operation on the biliary tract was finished, bacterial recovery from gallbladder tissue was significantly more frequent compared to bile. Under these last mentioned circumstances, the difference in bacterial recovery was due to bacterial species like Staph. aureus, Staph. albus, P. acnes and Difteroids.


Total devascularization of the Liver: an experimental model of acute liver failure. An experimental model of clinical liver failure, using total devascularization of the liver is described in the pit. The survival time was 1495 +/- 75 (SEM) minutes. Clinically the pigs showed a uniform course. They became lethargic after eight to ten hours and following a period of increasing drowsiness they became comatose. The immediate cause of death was cardio-vasculary collaps. The ammonium ion concentration in the blood increased to 696 +/- 57 umol/l and in cerebrospinal fluid to 664 +/- 57 umol/l. Cerebrospinal fluid glucose concentration was significantly decreased.


Total and partial anoxia of the liver. An attempt to create protracted liver failure in the pit. In an attempt to produce severe, but non-lethal experimental liver failure, pig livers were exposed to partial or total anoxia for various periods. The experiments were divided into 5 groups. Group I with total anoxia for 30 minutes, group II for 50 minutes, group III for 60 minutes, and group IV for 75 minutes. In group V a subtotal devascularization was performed. In group I (3 animals) and II (3 animals) all survived the period of observation (one week). In group III (4 animals) half of the animals, and in group IV (3 animals) all died within 24 hours. In group V (10 animals) five of 10 animals died with a mean survival time of 22 hours and a half. The animals surviving the period observation did show changes in the routine liver tests, but none of them showed clinical signs of liver insufficiency. This indicates that the differences between lethal and clinically insignificant liver damage is very small. It is concluded that the pig lever can tolerate 50 minutes of total anoxia and recover almost completely after one week, and that a period of anoxia or subtotal devascularization does not create protacted liver failure.


Disappearance of gastrin heptadecapeptide in the isolated perfused pig liver. To elucidate the role of the liver in gastrin metabolism three liver perfusions and two control experiments were performed; 2,5, 5 and 250 microgram of porcine nonsulphated gastrin-17 were injected into a perfusate of pig blood circulated through an isolated perfused liver. A significant decrease of gastrin concentration was observed during liver perfusions, concentration being halved in 35 minutes with all doses. It is suggested that this decrease is due to hepatic degradation and that the liver may play an important role in metabolism of gastrin-17.


Serum-gastrin in cirrhosis.

Serum-gastrin in cirrhosis. Fifty patients with cirrhosis of the liver had gastrin concentrations in serum above normal when measured in the fasting state. Hypergastrinaemia predominated in non-alcoholic cirrhosis. In both groups of patients, serum gastrin levels were higher in patients with inactive cirrhosis than when cirrhosis was slightly active.


Inhibition of gastric secretion by exogenous secretin and cholecystokinin in normals and duodenal ulcer patients. The inhibitory effect of combined secretin (0.5 and 1.0 clin. unit/kg b.w./hour) and cholecystokinin (0.5 and 1.0 IDU/kg b.w./hour on the pentagastrin-stimulated (0.15--1.0 and 6.0 ug/kg b.w./hour) gastric secretion was investigated in twelve volunteers and in twelve duodenal ulcer patients. Regardless of the dose level no difference was found between normals and duodenal ulcer patients, indicating that a decreased sensitivity to secretin and cholecystokinin is not a pathogenetic factor for the development of duodenal ulcer.


Combined effect of glucagon and cholecystokinin on gastric secretion in man. The inhibition of the pentagastrin-stimulated (1 ug/kg b.w./hour) gastric secretion by glucagon (20 ug/kg b.w./hour), cholecystokinin (0.5 IDU/kg b.w./hour), and a combination of these were investigated in 7 volunteers. Glucagon as well as CCK given isolated inhibited the gastric secretion, but no augmentation of inhibition was demonstrated when the hormones were in combination.


Isolation and perfusion of the porcine pancreas. The isolation of a porcine pancreas preparation without the attached duodenum is described. The preparation is suitable for study of the secretion of insulin and pancreatic glucagon. The surgical procedure by which the pancreas is removed from tha animal is decribed as well as the perfusion system. The effect of various concentrations of glucose (63, 90, 135 and 180 mg per 100 ml) in the perfusion medium on the secretion of insulin and pancreatic glucagon was investigated in order to observe the performance characteristics of this preparation. Increasing concentrations of glucose caused a significantly greater insulin release, whereas the glucagon response was significantly reduced.


Influence of basal plasma glucose concentration on the glucagon response to arginine. Plasma glucose and glucagon concentrations were measured in the portal vein of six healthy, anaesthetized pigs submitted to an intravenous arginine infusion test. A monophasic glucagon response was observed in all pigs, the peak glucagon value being reached within an average of 5 minutes after the beginning of the infusion. The glucagon response, expressed as the incremental area below the hormone concentration curve, correlated inversely with the plasma glucose concentration before the start of arginine infusion (r=0.78) (p less than 0.05) indicating that glucose is a potent inhibitor of arginine-induced glucagon secretion in pigs.


Insulin secretion in the Zollinger-Ellison syndrome. The insulin response to oral glucose ingestion was measured in six patients with the Zollinger-Ellison (ZE) syndrome, five patients with partial gastrectomy (antrectomy for duodenal ulcer) and six matched normal subjects. The blood glucose curves were similar in ZE-patients and gastrectomized controls and significantly above the glucose concentrations in normal controls. The insulin response was three-doubled in ZE-patients, whereas gastrectomized controls only doubled their response in comparison with the normal subjects. Treatment of a hepatic gastrinoma by streptozotocin infusion into the hepatic artery in a patient with diabetes mellitus and hyperinsulinism almost normalized his glucose tolerance and insulin secretion. The results demonstrate that the ZE-syndrome is associated with increased insulin release. We suggest that the hyperinsulinism partly is a consequence of previous gastric surgery and partly due to the insulinogenic effect of gastrin.


Principles in operative treatment of residual bile duct stones. Of sixty-five patients with residual bile duct stones 17 patients had a supraduodental choledochotomy as the only operative procedure. Of the remainder, 48 patients, a supplementary sphincteroplasty was carried out in 36, and a choledochoduodenostomy was added in 12 patients. Early postoperative results showed two deaths, while 40 patients passed an uneventful postoperative course. Following sphincteroplasty three patients had residual stones at the postoperative cholangiography. These calculi had disappeared at follow-up examination. Follow-up examination with a mean observation period of six years revealed 50 patients free of symptoms. Four patients were re-operated on because of residual stones. None of these had a sphincteroplasty. It is concluded that in the operative treatment of residual bile duct stones sphincteroplasty and choledochoduodenostomy offer valuable supplements to the supraduodenal choledochotomy.


The vagus and gastrin components in peripheral blood. To study the role played by vagal activity for the gastrins in peripheral blood, the mean pattern during feeding was studied in 16 duodenal ulcer patients before and after selective (n=8), or truncal vagotomy (n=8). Two normal subjects were studied with and without atropine during hypoglycaemic activation of the vagus. Gastrins were fractionated by gel chromatography. Serum gastrin was almost exclusively made up of gastrin component II (gastrin 34-like) and III (gastrin 17-like). Both components rose after feeding but the major increase was incomponent III. Total gastrin concentrations rose after vagotomy but no qualitative changes were seen. During hypoglycaemia a marked increase in gastrin component III and a lesser increase in component II was found. This pattern was not changed by atropine. It is concluded that the vagus plays little or no role for a selective release of the various gastrins. Furthermore there is no indication that the higher serum levels after vagotomy consist of gastrins of a lesser biological activity.


Gastrin content and gastrin release. Studies on the antral content of gastrin and its release to serum during stimulation by food. To examine the release of gastrin by food from antral mucosa eight patients were stimulated for 30 minutes by instillation of bovril during gastroscopy. Bovril caused a steady increase in serum concentrations of gastrin and an acute fall in the antral content of gastrin to 42+/-8.4 per cent after 10 minutes. After 10 minutes the antral content increased again towards the basal values. No change in gastrin components could be detected; component III (gastrin-17) constituted more than 95 per cent of the antral gastrins throughout the 30-minute period. The serum gastrin response to a steak meal was higher in 22 duodenal ulcer patients than in nine young normal subjects and it was higher postoperatively in eight patients studied before and after truncal vagotomy. In the duodenal ulcer patients whith the highest antral content of gastrin, the serum response to food was higher only during the early phase of the feeding response. It is concluded that the gastrin content of the antral mucosa represents an acute releasable pool of gastrin-17, which contributes only to the first 10-15 minutes of the feeding response. It does not reflect the total amount of gastrin released into the circulation during feeding.


On the beta-adrenergic contribution to the gastric acid and gastrin responses to hypoglycaemia in man. To study the beta-adrenergic contribution to the hypoglycaemic stimulation of gastric acid and gastrin release the effect of an equal and extensive beta-adrenergic blockade with three drugs was studied. Propranolol was investigated in 12, pindolol in 22, and practolol in 11 patients. Fasting concentration of gastrin serum and spontaneous acid secretion were not reduced by the drugs. Propranolol eliminated the gastrin response to hypoglycaemia, pindolol reduced it, and practolol caused no alteration. The hypoglycaemic acid response was reduced by all three drugs, propranolol reduced the response to one-half and was the strongest inhibitor, practolol the weakest. It is concluded that beta-adrenergic receptors may be of major importance for the hypoglycaemic stimulation of the stomach, but the receptors respond differently from the receptors in the heart.


Effect of epinephrine and norepinephrine on gastrin release and gastric secretion of acid in man. To study the physiological importance of epinephrine and norpinephrine for gastrin release and gastric secretion of acid the effect of intravenous infusions was investigated. Two doses were used (5 and 50 mg per kg per minute in one hour), the low dose of epinephrine and both doses of epinephrine (n=20) stimulated gastrin release and acid secretion, whereas the high dose (n=8) stimulated the gastrin release strongly, but did not change acid secretion. Norepinephrine in the low dose (n=11) caused a very small increase in gastrin release and no change in acid secretion, whereas the high dose (n=11) inhibited acid secretion without any change in gastrin concentration. No postoperative change was observed in the release of gastrin by both doses of epinephrine after truncal vagotomy in sex and seven patients with duodenal ulcer. It is concluded that epinephrine and norepinephrine both may be of importance in the physiological regulation of gastrin release and gastric acid secretion.


Gastrin response to food after three types of intestinal shunt operations for obesity. In a retrospective study the basal and food-stimulated serum concentrations of gastrin and gastric secretion of acid were studied in 28 patients following three types of intestinal shunt operation for obesity. In each type 48 cm of functioning small intestine was preserved, but the ratio between functioning jejunum and ileum was different. The basal and stimulated concentrations of gastrin in serum were significantly higher in patients with the shortest jejunum in function. There was no difference in the gastric acid output. The study suggests that gastrin participates in evoking the gastric hypersecretion of acid which follows massive bowel resection or bypass. Deprivation of a hormonal inhibitory substance from the upper jejunum may be responsible for the increased serum gastrin concentration.


The failure of granulocytes to produce transcobalamin I TC I. The hypothesis that transcobalamin I (TC I) originates from granulocytes was tested by comparing the isoelectric focusing (IEF) patterns of the R-type binder (cobalophilin) of vitamin B12 of: 1) lysed granulocytes, 2) 24 h granulocyte output, and 3) plasma. The preparations came from the blood of 5 normal subjects and 4 with myeloproliferative states. The cobalophilin released into a culture of granulocytes resembled the binder in the granulocytes initially. TC I, defined as the alpha1 cobalophilin with components isoelectric between pH 2.9-3.35 and as a carrier of native plasma B12, was not released by granulocytes. The granulocyte binder of leukaemic granulocytes did not differ from the normal in content per cell or amount released.


Carcinoembryonic antigen (CEA). A prospective clinical trail in patients with gastrointestinal cancer. Tests for circulating carcinoembryonic antigen, CEA, in plasma were performed in 29 patients with colonic and rectal cancer, 37 patients with stomach cancer, and in 100 blood donors. Using 5.0 ng per ml as cut off, 48 per cent of the patients with colonic and rectal cancer and 32 per cent of the patients with stomach cancer had elevated CEA-values. The CEA-values could be correlated to the classification of tumours according to Dukes, with significantly elevated values in groups Dukes C and D. The test could reveal 39 per cent of the cases with operable colonic and rectal cancer and 26 per cent of the operable cases of stomach cancer. Five patients with colonic and rectal cancer, and 0 patients with stomach cancer fulfilled the requirements for monitoring. After periods of observation of up to 14 months, definite connection between CEA-values and clinical course could be demonstrated in 1/26 patients submitted to macroscopically radical operation. In 2/7 patients with stomach cancer the CEA-values were entirely misleading. It is concluded that the CEA-test in its present form cannot be recommended for routine employment in patients with gastrointestinal cancer.


Relationship between smoking and the single breath nitrogen washout.


Added apparatus dead space in the N2-closing volume test: - a refinement or a bias. 14 subjects without symptoms of cardiopulmonary disease underwent paired closing volume determinations by the modified single breath nitrogen test. Measurements were performed with an apparatus dead space of approximately 40 ml and approximately 350 ml. A rise in closing volume percent for all subjects was found in measurements with dead space of 350 ml. This Difference was statistically significant at the 0.001 level for the group as a whole. No change in the accuracy of the method, expressed as the standard deviation of each subjects values with and without added dead space cojld be demonstrated. Linear regression analysis of the closing volume percent values measured with added dead space as a function of closing volume percent values measured without added dead space showed the expected highly significant positive correlation. However the regression line was not parallel to line of identity, indicating that the higher the initial value of closing volume percent the higher rise after addition of apparatus dead space. With reference to characterizing a person as normal or abnormal this could be considered a refinement of the method.


Heart synchronous oscillations in the alveolar plateau and closing volume.


Epidemiological limitations of the nitrogen closing volume test. Closing volume was measured in 216 men aged 46-68 years. They were divided in 5 age groups and classified as either symptomatic or asymptomatic according to answer to standardized interviews. In 3 of 5 age groups mean value for closing volume percent (CV%) for symptomatic persons was lower than the mean value for asymptomatic persons. CV% is not considered useful as the dependent variable in a multiple regression analysis. In all 5 age groups the mean value of slope of alveolar plateau was higher for symptomatic than for asymptomatic persons. Slope af alveolar plateau is considered useful as dependent variable in a multiple regression analysis. One of the reasons for the false negative CV%-values is believed to be influence of increased uneven and sequential ventilation of the lungs, expressed in the slope of alveolar plateau.


Diurnal variability of closing volume measurements in normal subjects.


Several methods of measurements of closing volume and their compared results.


The effect of 15 ME-PGF2alpha on the N2-closing volume.


The volume of trapped gas, closing volume and pulmonary gas exchange in smokers and non-smokers aged 60.


Airway stability during anaesthesia with artificial ventilation.


Lung volumes and arterial blood gases in obesity. Lung volumes and arterial blood gases have been studied in six severely obese patients (mean weight 143 kg), admitted for jejunoileal shunt-operation. The lung volumes were recorded on a Siemens constant volume body plethysmograph, and the arterial blood gases were measured by means of a Radiometer ABL-1 blood gas analyzer. The patients were in the seated body position. The Functional Residual Capacity (FRC) was found to be 40% (mean value) of Total Lung Capacity (TLC). Predicted normal value of FRC/TLC% in non-obese subjects of the same height, sex and age is 54%. During tidal breathing the arterial oxygen tension (PaO2) was 84 mm Hg (mean value) compared to 95 mm Hg in non-obese subjects. A positive correlation between FRC/TLC% and the PaO2 was found. A series of 5 deep breaths normalized the PaO2 which rose by 18 mm Hg to 102 mm Hg (mean value). These results confirm the generally held opinion that the main abnormality of lung function in obesity is a reduction of lung volume to such a low value that airway closure occurs during tidal breathing, causing arterial hypoxemia.


Closing volume and gas exchange in obese patients before and after intestinal bypass operation. (A preliminary report).


The closing volume as a screening test in smokers.


Airway closure and expiratory flow-limitation in relation to smoking habits and symptoms of CNSLD.


Closing volume. The effects of acute exposure to tobacco and tobacco substitute mixtures.


Effect of reduced inspired volume on measurement of closing volume.


Nitrogen closing volume-test in 50- and 60- year-old men.


Alternatives to insecticides.

Alternatives to insecticides.


Seventy-three year old caucasian male with a renal mass of several years duration.


Problem solving in diagnostics and therapeutics of neurology. A series of 24 lectures lecture No 7. Clinical patterns of brain stem lesions.


Concepts in perinatology. Some practical points.


Screening thyroid function tests.

Screening thyroid function tests.


Clinical patterns of cerebellar lesions.


Thirteen year old girl with one month history of back pain and limp.


Hypertension screening.

Hypertension screening.


Problem solving in diagnostics and therapeutics of neurology. Focal cord deficits.


Complications of cardiac pacemakers.

Complications of cardiac pacemakers.


Clinicopathological conference: seventy-seven year old caucasian female with cecal mass demonstrated on X-ray.


A metacarpal giant cell tumor, a sternal osteoblastoma and a pubic osteogenic sarcoma in the same patient.


Transfer of in vitro cytotoxicity against osteogenic sarcoma cells. Evidence of lymphocyte cytotoxicity against osteosarcoma, suggesting a degree of cell-mediated immunity, was found in the mother of a patient with osteogenic sarcoma. The mother was found to be HL-A identical to the patient and therefore was an ideal donor for whole lymphocytes. Lymphocytes were obtained from the mother by leukophoresis and were administered to the patient. Lymphocytotherapy transferred or re-established a delayed hypersensitivity response to mumps antigen and transferred the ability of killing osteogenic sarcoma cells in vitro. There was slight improvement in the patients' clinical condition coincident with the establishment of lymphocytoxicity in the patient. Loss of this capacity coincided with a rapid deterioration of the patient's condition.


The Food and Drug Administration's requirements for approval of new dental drugs.


The effect of immigration on genetic control.


Chromosome changes in patients treated with "Myleran". The aim of this study is the determination of chromosomal changes in patients suffering from chronic leucosis, after therapy with the cytostatic "Myleran", to find out whether this cytostatic causes them, because of clinical experience which indicates its value in the treatment of chronic myeloid leukemia. Patients were treated with therapeutic doses of 4 mg per os daily. Analysis with present methods in patients receiving relatively small total doses did not discover the other visible chromosomal aberrations in leucocytes in peripheral blood, except the usual aberrations caused by chronic leucosis.


Incidence of naso-lacrimal atresia in infants of primiparae.


Vitrectomy via the pars plana. Film commentary.


Electro-mechanical vitreous cutter and extractor.


Complications after retinal detachment surgery.


Rhegmatogenous retinal detachment in patients aged 40 years or less.


Corneal problems after retinal and vitreous surgery.


Alacrima.

Alacrima. Alacrima, a congenital lack of tears, is a comparatively rare condition. Seven cases are presented, and the possible aetiology discussed. All cases should be followed up in view of the possible development of the full sicca syndrome later in life. Alacrima should be considered as an underlying condition in cases of red irritable eyes in young children, even in the absence of a definite history from the parents.


Mechanism of retinal attachment after cryosurgery.


Giant tear of the retina.

Giant tear of the retina.


Macular hole and retinal detachment.

Macular hole and retinal detachment.


Outstanding problems in retinal detachment. Management of vitreous and retinal detachment in diabetic retinopathy.


Value of general anaesthesia in cataract surgery.


Functional recovery of the retina after retinal detachment.


Peripheral retinal degenerations.

Peripheral retinal degenerations.


The cataract incision.

The cataract incision.